Manager – Hospital Billing

Job Family:

PFS General

Travel Required:

Up to 10%

Clearance Required:

None

What You Will Do:

The Hospital Billing Manager is responsible for overseeing the daily billing functions for hospital and healthcare revenue cycle operations. This position ensures that the billing operations are in accordance with established policies, procedures, and internal controls.

The ideal candidate is a hands-on leader with strong hospital billing and reconciliation experience, excellent critical-thinking skills, and experience working within hospital patient accounting systems, including Epic, MEDITECH Magic, and MEDITECH 6.x/Expanse environments.

Essential Job Functions

• Leadership / Training
• Billing / Cash Posting / Collections
• Compliance
• Reporting

Duties and Responsibilities

• Acts and leads in a manner that will instill trust and foster team play.
• Ensures that all employees know and understand all State and Federal Rules and Regulations.
• Ability to make good judgment and quick decisions, strong AR acumen
• Provide a working environment which allows employees to communicate ideas for improvement to department. Whenever possible request employee input on policies and procedures that may affect or impact the way their job is performed.
• Maintain open communications and provide appropriate feed back to PBA staff and management.
• Allow employees to attend seminars which will enhance productivity and knowledge.
• Ensures employees have all the tools necessary to achieve the goals set.

Billing/Cash Posting/Collections:

• Experienced in driving cash and AR account resolution.
• Working with all payers for resolution and escalation.
• Experienced with expected reimbursement variance management.

• Works with all departments to ensure accuracy of CPT4, HCPCS and Revenue Codes.
• Provide departments with Medicare and other payer updates, notices and coverage changes which effect both billing and reimbursement.
• Reviews process and systems to ensure the most effective methods are maintained to meet all departmental and facility goals.
• Works with IT to ensure that all changes are completed to ensure accuracy of billing is maintained.
• Ensures bill hold in electronic systems meets established goal.
• Works with both electronic billing vendor and payers to resolve billing/cash posting issues.
• Identifies and resolves problems in the patient accounts receivable process and when appropriate initiate changes to rectify payer issues, underpayments and denials.
• Reviews and approves credit arrangements, refunds, write-offs and adjustments on accounts and insures departmental and medical center policy regarding signature levels are followed.
• Manages all employees providing follow-up on third party and self-pay accounts post initial billing.
• Prepares, distributes, and presents daily, weekly, and monthly reporting packages as required.
• Monitors overall performance and productivity in department.
• Ensures all reports are completed timely.
• Acts as a technical resource for Medicare regulations and reimbursement.
• Ensures that all components of the Medicare Bad Debt Log and supporting documentation are complete.
• Oversees Completion of Bad Debt vendor reconciliation.
• Informs management of all compliance issues.
• Assigned special projects will be completed within the time frames given.
• Appropriately documents each account worked in patient accounting system.
• Ensures all established goals are met.
• Develops and executes projects to reduce aged A/R and enhance collections.
• Understand and manages client service level metrics and key indicators of revenue cycle performance.  Develop and adhere to methods of KPI improvement.

Compliance:

• Communicates all compliance issues to Manager.
• Educates and ensures that all employees understand Compliance and appropriate procedure for reporting compliance issues for State, Federal and HIPAA.
• Attends pertinent seminars, internal and external and shares obtained information with staff and other appropriate departments.
• Reviews and maintain JACHO requirements for billing, cash posting and collections. 

Reporting:

• Responsible for the weekly Key Indictor Reports
• Patient Accounting and Billing Scrubber reports to departments daily.
• Maintain logs by department for claims on hold status.
• Daily electronic and paper claim report.
• Other reports as requested by management.

What You Will Need:

• Requires a bachelor’s degree and a minimum 7 years of prior relevant experience. (Relevant experience may be substituted for formal education or advanced degree.)
• 5 years of healthcare revenue cycle, hospital billing experience
• Epic, MEDITECH Magic, and/or MEDITECH 6.x/Expense experience
• Of the seven years of relevant experience required, a minimum of two years must include people management experience.

What Would Be Nice to Have:

• Solid understanding of healthcare revenue cycle.
• Demonstrated competency in working in teams and ability to effectively communicate with all levels.

#IndeedSponsored

#LI-DNI

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or [email protected].  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact [email protected]. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.